title: Association between smoking cessation and short-term health-care use: results from an international prospective cohort study (ATTEMPT).
abstract: OBJECTIVE
  Previous studies have found that smoking cessation is associated with a short-term increase in health-care use. This may be because 'sicker' smokers are more likely to stop smoking. The current study assessed the association between smoking cessation and health-care use, adjusting for pre-cessation physical and mental health conditions.
  
  
  METHODS
  Data came from the ATTEMPT cohort, a multi-national prospective survey of smokers in the United States, Canada, United Kingdom, France and Spain, that lasted 18 months (with follow-ups every 3 months).
  
  
  METHODS
  A total of 3645 smokers completed the baseline questionnaire. All participants smoked at least five cigarettes per day, intended to quit smoking within the next 3 months and were between 35 and 65 years of age.
  
  
  METHODS
  Participants were asked questions about their socio-demographic and smoking characteristics, as well previous smoking-related morbidities. Participants were also asked to report their health-care use in the previous 3 months i.e. emergency room (ER) visits, hospitalization, whether hospitalization required surgery, and health-care appointments.
  
  
  RESULTS
  A total of 8252, 4779 and 1954 baseline episodes of smoking were available for 3, 6 and 12 months, respectively. Of these, 2.8% (n = 230), 0.9% (n = 40) and 0.7% (n = 14) were followed by 3, 6 and 12 months of abstinence. No significant differences were found among 3, 6 or 12 months of abstinence and ER visits, hospitalization and whether hospitalization required surgery or health-care visits. However, 6-month smoking cessation episodes were associated with higher odds of reporting an appointment with a dietician.
  
  
  CONCLUSIONS
  Smoking cessation does not appear to be associated with a substantial short-term increase or decrease in health-care use after adjusting for pre-cessation morbidities.
authors.affiliation: Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Beard
authors.forename: Lion
authors.initials: L
authors.lastname: Shahab
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Curry
authors.forename: Robert
authors.initials: R
authors.lastname: West
mesh_terms: D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D002170:Canada / Q000453:epidemiology; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D057566:Self Report; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
keywords: Cigarettes; cost-benefit analysis; health-care costs; health-care use; hospitalization; smoking cessation